In 1978, fresh out of college, I traveled to the South Pacific to study man’s relationship to the sea in isolated island communities. I settled in with a family in a tiny village at the end of a dirt road on Raiatea, in French Polynesia.

On my first night with them, without thinking about it, I used the western-style toilet in their thatched house. That was a mistake. They had such a toilet only because the house had been built by an American visitor decades earlier (foreigners couldn’t own property). Only afterward did I realize the toilet wasn’t hooked up to any plumbing. Embarrassment doesn’t begin to describe my feelings. As I would figure out a bit later, they did what needed to be done on a nearby beach.

Almost everywhere, sanitation is not an easy subject. But the lack of it kills far more people each year than warfare does.

On Thursday, the United Nations Development Program held an event in Manhattan aimed at raising the profile of one of our most basic needs — a place to defecate — and highlighting the glaring lack of sanitary ways to accomplish this fundamental facet of biology in the world’s poor places.

At one of the busiest entrances to Central Park, two-dimensional figures created by a group called the German Toilet Organization (I kid you not) squatted behind a variety of objects –- an umbrella, a briefcase, a boulder –- for an unmistakable purpose. Each figure was emblazoned with a logo asking, “Where would you hide? 2.6 billion people toiletless.”

Fatimah Bamun, 14, was the only girl in her fourth-grade class in Balizenda, Ethiopia, where a lack of sanitation threatens education for girls. (Credit:
Vanessa Vick for The New York Times)

At the event in Manhattan, about 20 people held signs with numbers and related statistics. One was 194. The message? About 194 million school days are lost each year, in part because many girls stay home when schools lack toilets. (And often the school toilet is the worst in many rural villages.)

The man holding number 63 was Ingvar Anderson, who recently retired after several decades working to advance sanitation for the United Nations, mainly in sub-Saharan Africa.

“The toilet is something we always put at the back of our minds,” he said. “In the United States, you don’t even say you’re going to the toilet. You’re going to the bathroom, or the restroom.”

In East Africa, where he spent many years, he said that village men, heading out discreetly to do their business, would use a Swahili phrase that means “going to dig some roots.”

Olav Kjorven, the director of the bureau for development policy of the U.N.D.P., said the fraction of humanity without adequate toilets and sanitation had dropped to 42 percent in 2002 from 51 percent in 1990, but said that was grossly inadequate.

“This is an amazing policy failure,” he said, noting that studies had estimated that every $1 spent on sanitation produced $9 in improved productivity through better health and other benefits.

“The economics are there, the technology is simple, and the morality of it is clear,” he said. “What’s lacking is the will.”
[UPDATE, 3/21, 9 a.m.:]
There are plenty of technologies for dealing with feces at various levels of sophistication and cost. Search for “ecological sanitation” to get a view. Here’s one design, illustrated in a YouTube video:

But humanity continues to move ever more to towns and cities, with the density and numbers far outpacing the development of infrastructure. I’ll be exploring this question later this year. It’s, well, not pretty, but pretty vital to figure out in a world heading toward 9 billion individuals, each with a digestive system with two ends.